Healthcare Provider Details
I. General information
NPI: 1013525740
Provider Name (Legal Business Name): ELIZABETH FERBER LINDVIG DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/20/2020
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
130 S BRYN MAWR AVE
BRYN MAWR PA
19010-3143
US
IV. Provider business mailing address
45 BRAGG HILL ROAD
WEST CHESTER PA
19382
US
V. Phone/Fax
- Phone: 484-337-3000
- Fax:
- Phone: 610-764-3107
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | SC007090 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | SC007090 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: